OP0177-HPR HEALTH-RELATED QUALITY OF LIFE PROFILES OF ADULTS WITH ARTHRITIS
Authors: E. Knight, K. Carluzzo, B. Reeve, J. Singh, K. Mueller, L. Lin, K. Schifferdecker
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Adults with arthritis display poorer health-related quality of life (HRQOL) than the general population, including greater anxiety, depression, pain, and fatigue, and poorer physical function. Still, arthritis is a variable disease and the impact on HRQOL is heterogeneous in terms of severity and domains of impact. Some factors are associated with HRQOL outcomes in adults with arthritis, though research often focuses on a single outcome (like pain) rather than multiple HRQOL domains simultaneously. Examining protective and risk factors against a constellation of HRQOL outcomes would be beneficial for treatment of arthritis as a disease that impacts multiple areas of patients' lives. <h3>Objectives</h3> We aimed to identify profiles of HRQOL impact using the NIH's Patient-Reported Outcomes Measurement Information System (PROMIS) measures in a sample of adults with arthritis (osteoarthritis, inflammatory arthritis, fibromyalgia; with other arthritis types). We also aimed to identify demographic and clinical factors associated with HRQOL profile membership that serve as protective or risk factors against poor HRQOL outcomes. <h3>Methods</h3> Data including PROMIS measures of physical and social function, sleep disturbance, anxiety, depression, fatigue, and pain interference (PROMIS-29) and emotional support were collected through a national foundation's online survey of adults with arthritis in the U.S. PROMIS T-scores are calibrated with the U.S. general population mean of 50 (SD = 10). Higher function T-scores reflect better functioning and higher symptom T-scores reflect worse symptom burden. We used latent profile analysis (LPA), a patient-centered modeling approach, to characterize the heterogeneity in arthritis patients by clustering them into HRQOL profiles, determined based on statistical model fit and clinical interpretability. Participants were assigned to a HRQOL profile, and we fit a multinomial logistic regression model with HRQOL profile assignment as the outcome (best HRQOL profile as reference group) to determine associations with emotional support and demographic and clinical factors. <h3>Results</h3> We included 25,305 adults with arthritis. The LPA results favored a five-HRQOL profile solution (entropy = 0.83). See Figure 1 for profile details and participant counts. Profile 1 (8% of sample), the best HRQOL group, displayed higher physical and social functioning and lower physical and mental symptoms. Profiles 3 (37% of sample) and 4 (10% of sample) were similar, except those in Profile 4 had reduced anxiety and depression similar to Profile 1. Profile 5 (20% of sample), the worst HRQOL group, displayed mean T-scores close to 2 SDs below the US general population mean. All of the demographic and clinical factors were significant, including arthritis type. Compared to being classified into the best HRQOL group, participants who were unable to work were 39 times (95% CI = 20.35-73.85) more likely to be in the worst HRQOL group as participants who were working. Notably, higher emotional support (95% CI= 0.88-0.89) and starting to exercise (95% CI=0.45-0.70) were associated with a lower likelihood of membership in the worst HRQOL group (Profile 5). <h3>Conclusion</h3> With the exception of the best HRQOL group, all the other HRQOL profiles (92% of sample) had poorer physical function and worse pain interference than the US general population, and elevated depression and anxiety, with some exceptions. Malleable factors such as emotional support and exercise served a protective function. These results highlight the value of considering multiple components of the patient's HRQOL experience alongside treatment options, and the potentially positive impact of interventions beyond medication. <h3>References</h3> [1] Dominick KL, Ahern FM, Gold CH, Heller DA. Health-related quality of life among older adults with arthritis. <i>Health Qual Life Outcomes</i>. 2004;2:5. [2] Matcham F, Scott IC, Rayner L, Hotopf M, Kingsley GH, Norton S, Scott DL, Steer S. The impact of rheumatoid arthritis on quality of life assessed using the SF-36: a systematic review and meta-analysis. <i>Semin Arthritis Rheum.</i> 2014;44(2):123-30. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Erin Knight: None declared, Kathleen Carluzzo: None declared, Bryce Reeve Consultant of: No COIs as it relates to this study, but Bryce has consulted with Takeda pharmaceuticals (has contract, Post-Doc Fellowship Program with Duke University School of Medicine with Bryce as PI); AstraZeneca (has contract, Post-Doc Fellowship Program, with Duke University School of Medicine with Bryce as PI); and GSK (has contract, Post-Doc Fellowship Program, with Duke University School of Medicine with Bryce as PI). Bryce consulted with Regeneron Pharmaceuticals last year but currently does not serve as a consultant. Bryce is currently consulting with Stoke Therapeutics., jasvinder singh Shareholder of: Jas owns stock options in TPT Global Tech, Vaxart pharmaceuticals, Atyu biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics Inc., Seres Therapeutics, Tonix Pharmaceuticals Holding Corp., and Charlotte's Web Holdings, Inc. Jas previously owned stock options in Amarin, Viking and Moderna pharmaceuticals., Speakers bureau: Jas is on the speaker's bureau of Simply Speaking., Consultant of: Jas has received consultant fees from Schipher, Crealta/Horizon, Medisys, Fidia, PK Med, Two labs Inc., Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point communications; and the National Institutes of Health and the American College of Rheumatology., Grant/research support from: Jas has received institutional research support from Zimmer Biomet Holdings., Kristen Mueller: None declared, Li Lin: None declared, Karen Schifferdecker: None declared.